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Cushing's syndrome: Stepwise approach to diagnosis
Anurag R Lila1, Vijaya Sarathi, Varsha S Jagtap
1Department of Endocrinology, Seth G. S. Medical College, Parel, Mumbai, Maharashtra, India.
Abstract:
The projected prevalence of Cushing's syndrome (CS) inclusive of subclinical cases in the adult population ranges from 0.2-2% and it may no longer be considered as an orphan disease (2-3 cases/million/year). The recognition of CS by physicians is important for early diagnosis and treatment. Late-night salivary cortisol, dexamethasone suppressiontesti, or 24-h urine free cortisol are good screening tests. Positively screened cases need stepwise evaluation by an endocrinologist. This paper discusses the importance of screening for CS and suggests a stepwise diagnostic approach to a case of suspected hypercortisolism.
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